VAGINAL & INSTITUTE SURGICAL TREATMENT - PAINFUL INTERCOURSE A BRIEF OVERVIEW FOR PATIENT REFERENCE

WHAT IS IT? Dyspareunia is the medical terminology for painful intercourse. The pain may occur with or after intercourse. Altered anatomy, post- operative changes, or physiologic conditions can all promote dyspareunia. Altered anatomy including uterine position or fibroids can become uncomfortable when manipulated during intercourse. Prior pelvic surgery and placement of vaginal mesh kits can affect the normal dimensions of the thereby producing dyspareunia. Physiologic conditions that occur with aging, such as thinning of the vaginal wall or a decrease in lubrication, may leave the vagina friable and vulnerable to pain during intercourse. Please see the Conditions section for more information on Dyspareunia.

TREATMENT OF DYSPAREUNIA FOR A SHORTENED/NARROWED VAGINA When the shortened/narrowed vagina is encountered, the Utilizing a full-thickness skin graft is another modality to surgical planning must consider the restoration of normal increase the caliber of the vagina to allow comfortable anatomical relationships. Often a patient will have a intercourse. This is a novel technique that Dr. Veronikis history of a previous with and/or developed based upon his extensive expertise and repair and notably did not have the vaginal vault technical skill in constructing for girls who are fixed as well. These patients may be treated with an born without one, also known as vaginal agenesis. abdominal vaginal vault procedure called an abdominal Typically a strip of skin from the abdomen is taken and sacrocolpopexy, which can lengthen and restore the placed within the vagina. Within a few weeks, the anatomical relationships. abdominal skin takes on the appearance of vaginal mucosa and women are able to enjoy intimacy again.

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TREATMENT OF DYSPAREUNIA FOLLOWING MESH PLACEMENT When mesh is placed judiciously and with the appropriate Our practice has experience with mesh removal, and surgical skill and dissection, it can be useful in the Dr. Veronikis has a national reputation for removal of treatment of prolapse and incontinence. However, several mesh whether exposed or eroded into other organs. women have suffered from the placement of too much Depending on the location and amount of mesh, if mesh inserted superficially or deep. When placed prolapse or incontinence remain, a second surgery may be superficially the mesh can become exposed in the vagina, required for reconstruction. The first surgery serves to causing both the patient and her partner to feel pain. remove all the mesh followed by a healing period for the When placed too deep, the mesh can erode into the vagina before the reconstructive operation. adjacent organs, such as the bowel or bladder. It may also Please see the Conditions and Surgical Treatments section involve nerve and muscle complexes causing pain at rest. for more information on Mesh Complications. Unfortunately many of these patients still have prolapse as well.

NOTE: This education content is for informational purposes only and not a substitute for professional medical advice, diagnosis, or treatment.

Always seek the advice of your physician or other qualified health provider if you have questions or concerns. If you are interested in a consultation with Dr. Veronikis or Dr. Wood, please ca for an appointment to address your specific needs.

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